Autonomic function in cyclic vomiting syndrome and classic migraine

Area of Science:

• Autonomic Nervous System Function
• Gastroenterology
• Neurology

Background:

• Cyclic vomiting syndrome (CVS) is an idiopathic disorder marked by severe vomiting episodes.
• CVS often occurs in individuals with a family history of migraine headaches.
• Autonomic dysfunction is suspected in CVS but requires further characterization.

Purpose of the Study:

• To characterize autonomic abnormalities in CVS patients.
• To compare autonomic function in CVS with pediatric controls, pediatric chronic vomiting, and adult migraine patients.
• To identify potential diagnostic markers for CVS.

Main Methods:

• Studied five groups: normal pediatric controls (NPC), pediatric chronic vomiting (PCV), cyclic vomiting syndrome (CVS), adult migraineurs (MHA), and normal adult controls (NAC).
• Assessed sympathetic adrenergic function (vasoconstriction to cold, postural adjustment ratio) and vagal cholinergic function (Valsalva ratio, ECG R-R interval).
• Utilized t tests for statistical comparisons between and within groups.

Main Results:

• Both CVS and migraine groups exhibited lower cholinergic function measures compared to controls.
• The most significant finding was a low postural adjustment ratio in CVS and migraine groups versus pediatric controls and PCV groups.
• Significant differences were observed between CVS and PCV groups in three other parameters.

Conclusions:

• Cyclic vomiting syndrome is associated with distinct adrenergic autonomic abnormalities, similar to those seen in migraine headaches.
• A low postural adjustment ratio is a characteristic finding in CVS.
• These autonomic findings may aid in the confirmation and diagnosis of CVS.